Early Intervention
Illinois Annual Performance Report

Participation in Early Intervention for Children Under the Age of Three

Part C State Annual Performance Report (APR) for FFY 07/SFY 08

Overview of the Annual Performance Report Development:

The Illinois APR documents performance data on State targets for each Child and Family Connections (CFC) office and documents CFC and state progress or slippage toward measurable and rigorous targets. The Illinois Early Intervention (EI) Program makes
the Illinois APR and State Performance Plan (SPP) available on its web site and through links from the other EI web sites (the Illinois Early Intervention Training Program; Provider Connections, the Early Intervention credentialing office; and the Early
Childhood Intervention Clearinghouse). The APR and SPP documents are also available to the public at each of the 25 CFC offices.

The APR is part an ongoing process of performance measurement and strategic planning for the Illinois Early Intervention Program. For a number of years, Illinois has been reporting performance data to key stakeholders including the Illinois
Interagency Council on Early Intervention (IICEI), the Child and Family Connections (CFC) offices, and the general public through various reporting mechanisms. Work groups of the IICEI have been formed to address specific indicators (Service Delay Work
Group and Transition Work Group) and overall operation issues (Finance Work Group). These work groups have helped analyze data and suggest improvement strategies.

Illinois utilizes a central client tracking system, Cornerstone. No activity can take place without a case being active in Cornerstone. Both service coordination agencies (CFCs) and the central office can pull reports to track the size and movement of
caseloads at any point. Since January 2002, the program has also utilized a standardized monthly reporting system on a series of performance measures, including total caseload and participation rate. Since the beginning of SFY 03 (July 1, 2002), Illinois
has operated a performance contracting system for CFCs, based on some of the more important measures found in the monthly statistical reports. Participation rates are reported for each CFC each month and this is one of the measures that carries
performance contacting incentive funding.

The bulk of funding for service coordination is distributed based on average caseloads over a recent period. Incentive funding is also distributed to CFCs that do the best job of limiting the number of families that leave intake or IFSP by choice or
because we cannot find them. Other incentives can be earned for doing the best job of completing IFSPs within 45-days and by providing the shortest average time between referral and initial IFSP. All of these factors have lead to a heightened awareness
of the importance of child find, good customer service and, ultimately, to higher participation rates. For instance, the reduction in the average time in intake from almost 80 days to under 30 days has resulted in an ongoing increase of approximately
2,000 children receiving IFSP services.

All of these activities are not only shared with CFCs monthly but also with the Illinois Interagency Council on Early Intervention (IICEI), as well as in other public forums, as appropriate. As a result of this continuous attention to child find and
participation rate and reporting on these activities, development of the APR only requires summarizing data already collected and distributed for FFY 07/SFY 08.

During FFY 08/SFY 09 Illinois state finances took a serious downturn. The situation for FFY 09/SFY 10 looked significantly worse but program trends pointed to the need for a significant increase in revenues, revenues that are not and will not be
available. With the help of the Illinois Interagency Council on Early Intervention (IICEI), the program had already taken a series of steps to make the program more efficient and effective but those actions were not enough, given the scale of the
problem.

The only conventional step left to take would be to increase the program eligibility standards. This is a step everyone wants to avoid. So, the program reviewed program data to identify steps that could be taken that would support program principles
but also save money. Data reports found significant differences in eligibility determination between different parts of the state. There also are similar differences in the amount of services authorized. In both instances it does not appear we are seeing
violations of the letter of program rules and law. Thus, nothing objectionable will be found in individual file reviews. However, what is happening does violate the spirit of the program. In too many cases the flexibility in the eligibility determination
process is being used to get around the stated requirement of a 30% developmental delay. In other instances it is clear that case plans are being written in a siloed medical model that is costly and burdensome for the family, instead of being written to
coach the family and maximize the impact of services.

To address this problem and avoid changing eligibility levels, the program will be implementing a new monitoring process we are calling System Ombudsman. This process will use data reports to identify where individual areas are performing outside of
the average range. The System Ombudsman make

on-site visits to conduct direct observation of plan development as well as directed file reviews, based on data pulls. The Ombudsman will make recommendations to the local community on changes needed to better conform with state norms and the EI
program philosophy. While the Ombudsman will make observations based on individual cases, their findings and work will be forward looking. As the name implies, the position will be geared to making system improvement. They will not attempt to impact any
individual cases.

Analysis of systemic differences in program administration between CFCs and the creation of a System Ombudsman function did not affect the collection of data for this report. However, we believe what has been found has contributed to caseload growth
now and in the past. Also, we believe that implementation of the System Ombudsman function will result in a notable reduction in the caseload during the later part of FFY08/SFY09 and through FFY09/SFY10. We have estimated the impact and adjusted our
goals for the remaining years of the SPP accordingly.

Percent = [(# of infants and toddlers birth to 3 with IFSPs) divided by the (population of infants and toddlers birth to 3)] times 100 compared to the same percent calculated for other States with similar (narrow, moderate or broad) eligibility
definitions.

Percent = [(# of infants and toddlers birth to 3 with IFSPs) divided by the (population of infants and toddlers birth to 3)] times 100 compared to National data.

FFY: 2007 (2007-2008)

Measurable and Rigorous Target: The percentage of all children in Illinois under age 3 served through an IFSP will be at least 3.32% on June 30, 2008, approximately 18,020 children.

Actual Target Date for FFY07/SFY08: On June 30, 2008, 18,467 children, representing 3.44% of all children in Illinois under age 3, received services through an IFPS.(18,467/536,149)*100=3.44%

Actual Target Data for FFY 07/SFY 08:

Participation Rate Goals & Actual Caseloads

June 30, 2007

FFY06/SFY 07 Goal

June 30, 2008

FFY07/SFY 08 Goal

Children with IFSPs

17,654

17,593

18,467

18,020

Participation Rate

3.31%

3.24%

3.44%

3.32%

On October 31, 2007, Illinois reported 17,489 children under 3 had active IFSPs, equal to a 3.11% participation rate. (17,489/536,149*100=3.26%). That is significantly higher than the 3.11% for the FFY 06 federal report. However, October represents a
traditional low point for the caseload. There were 18,467 open cases of children under 3 on June 30, 2008, representing a participation rate of 3.44% (18,467/536,149*100=3.44%). June 30 is both the end of the fiscal year and the traditional high point
for the caseload. Illinois' targets are set for June 30. The FFY 07/SFY08 goal of 18,020 was exceeded by 447.

This represented a 6.4% increase between federal 618 reports and a 4.2% increase from the end of FFY06/SFY 07 to the end of FFY07/SFY 08. Illinois' participation rate rank for FFY 06 moved down from 14th to 13th. The FFY07/SFY 08 reported caseload
represents a 65.5% increase over five years, compared to just 12.5% nationwide.

#: Totals excluding children classified as eligible because they are at-risk

^: For states listed as moderately restrictive in that year.

Participation Rate History
% of Children &lt; 3 Served

Rate

December 1, 2002

2.00

June 30, 2003

2.27

December 1, 2003

2.66

June 30, 2004

2.78

December 1, 2004

2.82

June 30, 2005

3.07

December 1, 2005

3.00

June 30, 2006

3.09

Oct. 31, 2006

3.11

June 30, 2007

3.31

Oct. 31, 2007

3.26

June 30, 2008

3.44

Between June 30, 2007 and June 30, 2008, 16 of 25 CFC caseloads saw caseload increases. All 25 have experienced increases in the last six years. Cook County, the collar counties and downstate areas all grew during FFY07/SFY08. Over the last six years,
the most substantial growth has taken place in Cook County. The downstate participation rate was slightly higher than Cook County. The collar county participation rate remains the lowest.

NOTE: CFC counts include the small number of cases open over age 3 for up to 30 days to facilitate final closing. No ongoing services can be paid for by EI. Participation rates are calculated based on births, instead of population estimates because
population estimates are not available to the necessary level.

Participation Rate History
By CFC & Region

CFC # & Name

End of SFY 02

End of SFY 03

End of SFY 04

End of SFY 05

End of SFY 06

End of SFY 07

End of SFY 08

Rank

FY 08% Change

6 Year
Change

#1 ROCKFORD

2.53%

2.86%

3.38%

3.43%

3.26%

3.33%

3.76%

7

12.9%

48.6%

#2 LAKE COUNTY

1.90%

2.03%

2.61%

2.75%

2.72%

2.57%

2.85%

24

10.9%

50.0%

#3 FREEPORT

2.76%

2.86%

3.34%

3.76%

3.49%

3.80%

3.45%

13

-9.2%

25.0%

#4 KANE-KENDALL

1.78%

2.15%

2.77%

3.06%

2.86%

3.03%

3.07%

21

1.3%

72.5%

#5 DUPAGE COUNTY

1.76%

1.95%

2.73%

2.92%

3.11%

3.24%

3.16%

20

-2.5%

79.5%

#6 N. SUBURBS

1.58%

1.92%

2.60%

2.90%

3.25%

3.62%

4.01%

4

10.8%

153.8%

#7 W. SUBURBS

2.17%

2.30%

2.87%

3.09%

3.43%

3.66%

3.84%

5

4.9%

77.0%

#8 SW CHICAGO

2.12%

2.38%

2.86%

3.19%

3.20%

3.27%

3.43%

14

4.9%

61.8%

#9 CENTRAL CHICAGO

1.93%

2.28%

2.71%

2.73%

3.11%

3.71%

3.65%

8

-1.6%

89.1%

#10 SE CHICAGO

1.98%

2.32%

2.75%

2.99%

3.15%

3.22%

3.03%

23

-5.9%

53.0%

#11 N. CHICAGO

1.43%

1.79%

2.28%

2.49%

2.75%

2.98%

3.31%

18

11.1%

131.5%

#12 S. SUBURBS

2.10%

2.50%

3.23%

3.37%

3.19%

3.33%

3.40%

16

2.1%

61.9%

#13 MACOMB

1.88%

2.32%

2.33%

2.71%

3.11%

3.48%

3.26%

19

-6.3%

73.4%

#14 PEORIA

2.03%

2.11%

2.40%

2.76%

2.90%

3.30%

3.55%

10

7.6%

74.9%

#15 JOLIET

2.21%

2.41%

3.07%

3.37%

3.36%

3.25%

3.53%

12

8.6%

59.7%

#16 BLOOMINGTON

1.79%

2.24%

2.41%

2.79%

2.91%

2.95%

3.42%

15

15.9%

91.1%

#17 QUINCY

2.51%

2.71%

2.63%

2.66%

2.81%

3.75%

3.55%

10

-5.3%

41.4%

#18 SPRINGFIELD

2.65%

3.14%

3.24%

3.46%

3.49%

3.54%

3.78%

6

6.8%

42.6%

#19 DECATUR

2.51%

2.49%

3.02%

3.06%

3.32%

3.70%

3.32%

17

-10.3%

32.3%

#20 EFFINGHAM

3.52%

3.46%

4.02%

4.35%

4.47%

4.67%

4.51%

2

-3.4%

28.1%

#21 BELLEVILLE

1.80%

1.86%

2.26%

2.48%

2.55%

2.57%

2.74%

25

6.6%

52.2%

#22 CENTRALIA

3.99%

4.03%

3.90%

4.36%

4.20%

4.46%

4.42%

3

-0.9%

10.8%

#23 NORRIS CITY

4.58%

6.19%

6.44%

7.82%

6.91%

6.98%

7.95%

1

13.9%

73.6%

#24 CARBONDALE

2.59%

1.82%

2.30%

3.03%

3.04%

2.80%

3.04%

22

8.6%

17.4%

#25 MCHENRY CO.

2.08%

2.49%

3.67%

3.45%

3.17%

3.12%

3.61%

9

15.7%

73.6%

Statewide

2.04%

2.30%

2.84%

3.07%

3.13%

3.30%

3.44%

4.5%

69.1%

Cook (6-12)

1.81%

2.14%

2.68%

2.89%

3.10%

3.35%

3.52%

5.1%

94.5%

Collar (2, 4, 5, 15, 25)

1.93%

2.16%

2.87%

3.06%

3.05%

3.05%

3.21%

5.2%

66.3%

Downstate (Others)

2.54%

2.75%

3.06%

3.38%

3.26%

3.46%

3.58%

3.5%

41.0%

Notes:

Rates inflated about 1.25% due to inclusion of children over 36 months but less than 37 months, waiting for transition process to be finalized,

Review of case counting methodology found that approximately 1.5% of the caseload was being excluded inappropriately as duplicates prior to end of FY 04.

The program's front door, represented by referrals continued to grow steadily through FFY07/ SFY08.

Since EI only has an average case for around 14 months, closings normally rise and fall in sync with openings but lag perhaps a year behind. During FFY 05/SFY 06, growth in new case openings was slowed, which produced a relatively flat number of case
closings in FFY 06/SFY 07. It was anticipated the gap between openings and closings would narrow during FFY07/SFY08 but it remained almost constant.

The Early Intervention program experiences a distinct seasonal pattern. In most years the caseload is flat during the first half of the year and there then is a spurt between February and June. In the second half of FFY08/SFY09 and FFY09/SFY10 the
program will be implementing a Program Integrity Project, discussed previously. It is anticipate that this project will depress the caseload marginally but noticeably for a year by reducing the proportion of referrals found eligible. This impact should
be fully realized in 12-14 months, after which a return to modest caseload growth is anticipated.

Discussion of Improvement Activities Completed and Explanation of Progress or Slippage that occurred for FFY 07/SFY 08:

Caseload growth exceeded expectation. The program did not introduce any new activities to increase child find and retention but continued to promote and refine its successful activities, including the performance contracting framework that rewards
successful child find activities. There was an expectation that growth in referrals would slow but it remained strong. In addition, growth in case closings was not as great as anticipated, due primarily to subtle changes in the age mix of the
caseload.

Illinois has experienced almost interrupted caseload growth since January 2002. This can be tied back to the creation of a strong system of incentives that encourage and support child find. However, at least two factors have led Illinois to develop a
new monitoring process to make sure the program is being administered uniformly statewide and in conformity with the philosophy of the program. First, the program grew by 65.5% in six years and it is reasonable to ask all that growth is reasonable.
Second, Illinois is experiencing serious financial problems. It is not possible to continue to support rapid program growth if it cannot be justified. A third underlying issue related to state finances is the desire of the whole EI community to avoid
changing eligibility standards. We would rather make sure we are only bringing in truly qualified and needy kids under the current system than make a change that would force us to deny services to kids who need them.

It is anticipated that the Program Integrity Project will result in a marginal but noticeable reduction in new initial IFSPs for 12-14 months. As a result, caseload targets are being adjusted as follows:

2008 (2008-2009):The percentage of all children in Illinois under age 3 served through an IFSP will be at least 3.38% on June 30, 2009, approximately 18,339 children. (No change is recommended for this target.)

2009 (2009-2010): The percentage of all children in Illinois under age 3 served through an IFSP will be at least 3.37% on June 30, 2010, approximately 18,020 children.

2010 (2010-2011): The percentage of all children in Illinois under age 3 served through an IFSP will be at least 3.43% on June 30, 2011, approximately 18,296 children.